Prioritizing what’s most important
What should the practical nurse do first?
What order should the practical nurse anticipate first?
What is the priority action of the practical nurse?
What is the most important clinical manifestation to report?
Is it better to notify the physician, apply oxygen or administer an analgesic? Should we
assist a client to a comfortable position or assess them on the floor? Should we prioritize a
client’s fever or their uncontrolled symptoms of bipolar disorder?
How are we to know what we’re supposed to do and when?
One of the greatest challenges of preparing for the CPNRE® is that there are few (if any)
guidelines to show us how to prioritize problems, assessments and interventions. Without
knowing how to prioritize, it’s challenging to make intelligent decisions on the CPNRE®
and why people often resort to guessing.
Understanding which assessments and interventions to prioritize enables us to ensure the
right clients get the right care at the right time. For this reason, the ability to prioritize is an
important skill in nursing, and on the CPNRE®.
The chart on the following page is a summary of some scenarios to be familiar with for your
exam.
Adapted from the 2019 NursEd CPNRE® Comprehensive Review eBook
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Question
Exam tactic
What order(s) should the practical
nurse anticipate?
Choose the answer option representing the physician’s
order that best addresses the most urgent clinical problem
described in the question
What should the practical nurse do
first?
If a question suggests a client has new or worsening
symptoms or change in status, choose the answer option
best reflecting one of the following three responses, in
priority order:
1. Assessment of the client.
2. Implementation of basic nursing intervention.
3. Notification of the physician.
What is the most important piece of
information the practical nurse
should provide the client?
Choose the answer option involving the practical nurse
giving the one piece of advice or information to a client
that if not given, could result in the most immediate harm
Which client should the practical
nurse attend to first?
If you’re asked to choose which client to care for and there
are four clients or situations competing for the practical
nurse’s time and attention, choose the one client or
problem that if not addressed, could result in the most
immediate harm
If you’re asked to choose one problem/symptom amongst
four abnormal findings, choose the one problem that if not
addressed now, could result in the most immediate harm
What
manifestation/observation/symptom
should the practical nurse report
first?
Adapted from the 2019 NursEd CPNRE® Comprehensive Review eBook
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